Individual provider Active NPI

Kaoru Namura, AG-ACNP

  • Acute Care Nurse Practitioner
  • Lincoln, CA
National Provider Identifier
1962007492
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95015067 Issued in CA
Practice address
130 Rosella PL
Lincoln, CA 95648-8923
Phone
(916) 396-6182
NPI assigned
Dec 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95015067 CA Primary
Critical Care Medicine Registered Nurse 163WC0200X 735902 CA

Addresses

Primary practice location

130 Rosella PL
Lincoln, CA 95648-8923

Mailing address

130 Rosella PL
Lincoln, CA 95648-8923
Phone (916) 396-6182

Other names 1

  • Kira Namura Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231009000435 CA Practitioner - Nurse Practitioner 0840645057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
735902CAMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Hospitals CurrentSince Aug 26, 2023 Accepting new patients
Sutter Valley Hospitals CurrentSince Aug 26, 2023 Accepting new patients
Sutter Valley Hospitals Current Accepting new patients

Locations

1625 Stockton Blvd
Ste 112
Sacramento, CA 95816
Phone (916) 887-4001

2825 Capitol Ave
Sacramento, CA 95816
Phone (916) 887-0000

Interoperability endpoints

  • Direct secure messaging: knamura303177@hisp.ehr.sutterhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1962007492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 ROSELLA PL",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956488923",
            "telephone_number": "916-396-6182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 ROSELLA PL",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956488923",
            "telephone_number": "916-396-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMURA",
        "first_name": "KAORU",
        "credential": "AG-ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95015067",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "735902",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRA",
            "last_name": "NAMURA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lincoln, CA

Sources for this page

Verify at the official NPI Registry.